Introduction to SNOMED CT
Why SNOMED CT? Features, Examples of
Use & Benefits
Presented by
Jo Oakes – Knowledge & Information Manager
PLEASE KEEP YOURSELVES MUTED WHEN NOT TALKING TO HELP
PREVENT BACKGROUND NOISE. THANK YOU.
1
Welcome
Useful links:
• UKTC website (see HSCIC) –
http://www.hscic.gov.uk
• Email for Information Standards helpdesk –
information.standards@hscic.gov.uk
• NHS Networks –
network name: SNOMED CT
http://www.networks.nhs.uk/
WHY SNOMED CT?
Electronic Patient Records
Quality Healthcare requires effective
communications
Effective communications need a
common language and a common
structure for humans AND for computers
SNOMED CT allows clinical data to be
recorded in a human recognisable and a
computer recognisable way
The Current Situation
Electronic
records
Paper records
OPCS-4
ICD-10
Read2
SNOMED CT
CTV3
Future Vision
Electronic
records
SNOMED CT
OPCS-4
ICD-10
Interoperable
• With an agreed structure, data can be passed from one
system to another but only if we use structured records
and a structured terminology
Choose
and
Book
GP
makes
referral to
Trust
Discharge
summary
sent to
GP
Coding systems don’t last
forever
LS1 4YH
020 .....
Read2 is getting full
SNOMED CT
Can be used by all healthcare domains.
Is a collaborative effort from a number of countries.
Denmark
Australia
Secondary
Care
Primary
Care
Community
Care
SNOMED
CT
Mental
Health
Canada
SNOMED CT
• The chosen terminology for the NHS
England
GP’s
Laboratories
Community
SNOMED
CT
A&E
Acute
Mental
Health
Use of
Synonyms
helps cater
for different
expressions
with the same
meaning
Terminology / Classification
• are used to populate a computerised
Classificationspatient
are intended
forand
population
record (EPR)
describe
related
to individuals and
can
Terminologies
statistics and concepts
analysis.
Terminologies
are
support the clinical decision making
designed to be
used by clinicians in their
process
recording of data in a patient record.
Maps between SNOMED CT and the
classifications
are provided
asusually
part of
the to
• categorise
concepts
relating
populations
or groupsclassification
of patients and
national product
set
to
support
Classifications
support business planning and
coding.purposes
epidemiology
Any Questions
Please put yourself on mute when not talking. Many Thanks
SNOMED CT
First things first
NHS –
Read codes
Clinical
Terms V3
SNOMED
CT
College of
American
Pathology –
SNOMED
RT
Source of Concepts in SNOMED CT 1999
SNOMED RT
CTV3
BOTH
NEW
SNOMED CT – What is it?
• SNOMED CT is a clinical terminology
Systematized Nomenclature of Medicine (Clinical Terms)
SNOMED CT – What is it?
• SNOMED CT is a clinical terminology
Systematized Nomenclature of Medicine (Clinical
Terms)
• Collection of names and words
SNOMED CT – What is it?
• SNOMED CT is a clinical terminology
Systematized Nomenclature of Medicine (Clinical
Terms)
• Collection of names and words
• Relevant to the field of medicine
SNOMED CT – What is it?
• SNOMED CT is a clinical terminology
Systematized Nomenclature of Medicine (Clinical
Terms)
• Collection of names and words
• Relevant to the field of medicine
• Organised in a structured and logically consistent
manner
SNOMED CT – What is it?
• SNOMED CT is a clinical terminology
Systematized Nomenclature of Medicine (Clinical Terms)
• Collection of names and words
• Relevant to the field of medicine
• Organised in a structured and logically consistent
manner
More ‘like’ a thesaurus than just a coding scheme
SNOMED CT Content
Clinical
Findings
Causes of
Disease
Procedures
•
•
•
•
Disease and deformity – scar
Symptoms – difficulty breathing
Social – walking aid use
Examination findings – tachycardia
• Forces – pressure change
• Events – road traffic accident
• Organisms – felis silvestris (cat)
•
•
•
•
Laboratory
Therapy / regimes
Investigation
Operation
SNOMED CT Content
Anatomy
Observations
Products
• Normal – knee joint
• Abnormal – ganglion cyst
• Lesions – bony callus
• Vital signs – blood pressure
• Body product properties – normal saliva
• Values - present
• Drugs and appliances – paracetamol
• Substances – latex
• Devices – bedpan
Sitting Blood
pressure
Blood
pressure
Lung
von Recklinghausen's bone
disease
Clinical ‘utterances’ are a Concept in the
terminology
toe
inflammation
mild
finger
moderate
ischaemic
infection
severe
acute
bacterial
cough
exertional
viral
angina
phlegm
A Concept
Codes and descriptions
Relationships
Is a
Attributes
Qualifiers
& values
A Concept in SNOMED CT
Preferred Term: Heart Disease
Synonym: Cardiopathy
Synonym: Disorder of Heart
Synonym: Morbus Cordis
Synonym: Cardiac Disorder
Synonym: Cardiac Diseases
Synonym: Heart Diseases
Heart disease (disorder)
56265001
Relationships
Is a cardiac
finding
Is a disorder of
mediastinum
Is a disorder of
cardiovascular
system
Finding site
heart
structure
Severity
Episodicity
Courses
Disease
Infectious disease
Disorder by body site
Infection by site
Disorder of trunk
Bacterial infectious disease
Disorder of thorax
Respiratory tract infection
Bacterial infection by site
Disorder of lung
Lower respiratory tract infection
Lung consolidation
Pneumonia
Bacterial respiratory infection
Infectious disease of lung
Infective pneumonia
Bacterial lower respiratory infection
Bacterial pneumonia
The Same Concept in CTV3
Preferred: Disorder of Heart
Synonym: Heart Disease
Synonym: Cardiac Disorder
X2003 Disorder of
Heart
Relationships
Is a
Cardiovascular
disorder
Finding site
cardiac
structure
Severity
Episodicity
A Concept in SNOMED CT
Preferred Term: Heart Disease
Synonym: Cardiopathy
Synonym: Disorder of Heart
Synonym: Morbus Cordis
Synonym: Cardiac Disorder
Synonym: Cardiac Diseases
Synonym: Heart Diseases
Heart disease (disorder)
56265001
Relationships
Is a cardiac
finding
Is a disorder of
mediastinum
Is a disorder of
cardiovascular
system
Finding site
heart
structure
Severity
Episodicity
Courses
Browser Demo
• Examples of concepts in a browser
Any Questions
Please put yourself on mute when not talking. Many Thanks
Subsets
What is a SUBSET?
• SNOMED CT is extensive – it is supporting a
common vocabulary for all healthcare specialisms,
and all healthcare professionals, as well as
keeping up to date with current practice
• A subset is ‘smaller set of SNOMED CT ‘ that
meets a particular requirement
• A SNOMED CT subset can be a group of
concepts, descriptions or relationships chosen for
relevance under certain conditions or in certain
contexts
Subsets
Why SUBSETS?
• It is often desirable to constrain the SNOMED
CT concepts available to a subset, say to help
faster data entry – so for example, all possible
performed procedures in a radiology department
or a theatre department
Subsets
HOW APPLICATIONS USE SUBSETS
• Supports easier navigation
• Can be used to limit to specific SNOMED
CT codes
• Can act like a ‘favourites’ for the end user
• Can be used nationally or locally –
synchronised national releases
• Access to subsets may be role based
Current Subsets Examples
Allergens
Diagnosis
Laterality
Radiology
procedures
EXAMPLES OF USE AND
BENEFITS
The World Changes…
Systems need to
support
Changing
behaviour
On-line
Knowledge Bases
widely available
• Changing demographics, increasing requirements
• Wider range of drugs
• Greater understanding of medical conditions
• People use the internet to research
• Peoples expectations with regard to knowledge and
care have changed
• Care Pathways
• NHS Evidence
• Map of Medicine
Summary Care Record
• Patient summary record
• Contains allergies, adverse reactions,
medications (current repeat, discontinued
repeat, acute). Additional information with
patients consent such as current diagnoses
e.g. diabetes, asthma
• This SCR clinical data is stored using
SNOMED CT
• Provides consistent recording and semantic
interoperability across a mixed coding domain
Choose and Book
GP produces referral letter as template or dictation
Consultant reviews and
accepts referral
GP and patient decide that referral
is appropriate, and creates
appointment request
Patient makes choice of provider with
information support
Appt. booked by the patient via internet or phone,
or in the practice
Other Applications using SNOMED CT
• Cerner – Millennium
• iSoft - Lorenzo
• CSE Healthcare Systems - RiO
Across Professions
Across different specialisms: orthopaedics,
cardiology, renal, microbiology, histopathology ...
Across primary, secondary, community, social
care, mental health
Synonyms – same concept said in different ways
to support cross discipline working
Communication – “Connect all”
Seamless transfer - coded information to
be electronically communicated - without
mapping
Translated into different languages:
Spanish, French, Swedish, Danish ...
Work starting in Lithuanian, Polish
International
Suppliers in different countries using the same terminology
Potential for improved functionality of systems as supporting
just one terminology
Collaborative effort: more cost effective
Links with other international standards – eg. World Health
Organisation
How can I look at SNOMED CT?
• There are various free to use browsers
available on the market. Details of those
that support the UK Edition of SNOMED
CT can be found in the UKTC:
• http://www.hscic.gov.uk
Learn more about SNOMED CT
Visit: Training and Resources on UKTC website
eLearning
future webinars
SNOMED CT NHS network
Documentation
Case studies
Any Questions
Please put yourself on mute when not talking. Many Thanks
Please take time to complete the Evaluation to help us
improve current provision and identify additional webinars
• UKTC website (see HSCIC) http://www.hscic.gov.uk
• Email for Information Standards help desk –
information.standards@hscic.gov.uk
• NHS Networks – SNOMED CT
http://www.networks.nhs.uk/
• International Health Standards Development
Organisation (IHTSDO) –
http://www.ihtsdo.org/